YOUR WIG MAY BE COVERED
Our team is dedicated to helping you find the ideal wig for those undergoing cancer treatment or dealing with thinning hair or hair loss. The best wigs for cancer patients can be affordable, as many insurance providers cover up to 100% of the cost for medical wigs, also known as cranial prostheses. If you are considering a medical wig due to hair loss, follow these steps to check if you are eligible for reimbursement from your insurance company.
step 1
CONFIRM YOUR COVERAGE WITH YOUR PROVIDER
Check with your insurance to determine what benefits are available for a "Cranial Prosthesis." It's important to use the correct terminology—avoid referring to it as a “wig.” Insurers see wig as cosmetic and not medically required.
Key Questions to Ask Your Insurance Provider:
- "Do you cover cranial prostheses?"
- "How much of the cost will be covered by my plan?"
- "What specific terminology should be used on the prescription?"
- "What HCPCS code is required on the sales receipt?"
Insurance Companies That been confirmed to offer Cranial Prosthesis Benefits:
- Aetna
- Blue Shield
- United Healthcare
- Humana
- TriCare
step 2
Obtain a Prescription | receive invoice
If you're experiencing medical hair loss, visit your doctor for a diagnosis. You will need a medical diagnosis for the condition causing your hair loss, along with a prescription for a cranial prosthesis.
We are essentially your pharmacy and will fill your prescription. After your order has been placed with us, we will create an invoice with the proper information and codes to provide to your insurance for possible reimbursement.
step 3
FILE AN INSURANCE CLAIM
Many medical insurance plans will cover partially or in full for your next human hair wig even if it is not listed on your policy of benefits.
Before purchasing your medical wig, contact your insurance provider to confirm coverage and obtain pre-approval. Be sure to use the term "cranial prosthesis" when inquiring about your policy, as the word “wig” is often considered cosmetic and may not be covered.
Here is what you will need to file your claim:
- Your Doctors Prescription
- Sales Receipt for Cranial Prosthesis with HCPCS billing code & Company Tax ID (provided by us)
- Completed Insurance Claim
- A DME (durable medical equipment) claim, if required by your insurance
WAYS TO STRENGTHEN YOUR CLAIM
- There are a few extra steps you can take to strengthen your claim before submitting to your insurance company, such as:
- Ask your physician to write a letter explaining hair loss & it's emotional effects
- Have your physician include their NPI Code on the diagnosis
- Ask your physician to sign off on your insurance claim form
- Hand-write an emotional letter explaining your situation, detail the effects the condition has had on your personal life
- Include photos of yourself without hair and makeup to show that the topper is not for cosmetic purposes
- Include a letter from your employer or a close friend, relative, spouse explaining the importance of having hair
WHAT TO DO IF YOUR CLAIM IS DENIED
If your insurance denies your claim, you have the option to appeal the decision or apply for financial assistance through grants or vouchers.
APPEAL
- Double check your benefits and coverage. See if your insurance uses a different term for Cranial Hair Prosthesis
- Ask for a review by a medical review board
- Ask for a written reply as to why the claim was denied
- Send a letter to the claims department supervisor
VOUCHERS
- American Cancer Society: Apply for a grant up to $75 to help cover the cost of a cranial prosthesis. Be sure to apply before purchasing the wig, as certain financial criteria must be met.
- National Alopecia Areata Foundation (NAAF): The Ascot Fund provides financial assistance to individuals with alopecia areata, with a special pre-purchase program to assist with wig costs.
We’re here to support you throughout your journey to find the perfect solution for your hair needs.
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